Torchlight Youth Registration Form ('24-'25)

Wednesdays, 7-8 pm | Please fill out this form and click submit.

Youth Info

Name

Birthdate

For example, 2/10/1996

Pronouns

Please select all that apply.

He/Him/His She/Her/Hers They/Them/Theirs Other

If you chose other, please share your pronouns.

Gender

Please select one option.

Female Male Non-Binary

Grade

Please select one option.

5th 6th

School

Please select one option.

Dakota Meadows MS Loyola Prairie Winds MS St Peter MS/HS Homeschool Other

If you chose "other", which school does your child attend?

Contact Info

Address

Additional Address

An additional address can include a physical address (as opposed to a mailing address), or the address of your child's secondary home.

This address will receive a confirmation email

Phone

If you have multiple emails or phone numbers to use for regular communication, include a semicolon between them.

Youth Cell Phone (if applicable)

Youth cell phone will only be used to send reminder texts or in an emergency. It will only be visible by staff members.

About Your Child

What most interests your child? (i.e. swimming, baking, reading, science, drawing, space, etc.)

Among adults, who does your child trust or feel comfortable around in our Bethlehem community? (You can give a general description of someone they connect with well if you can’t think of a name.)

Does your child have any food or life-threatening allergies?

Is there any other information that would be helpful for us to know?

Media Release

We may share appropriate photos or videos of your child participating in our program to tell the story of our church on social media. If you have concerns with this, please reach out to Anna Wencl (annawencl@blcmankato.org)

Please select one option.

I understand

Description

Wednesdays, 7-8 pm

Please fill out this form and click submit.

Torchlight Youth Registration Form ('24-'25)

Description

Please Fix the Following